Stroke victim has started biting tongue and lips when eating. Strokes happened 5yrs ago. Is this a sign of something more?

My mother-in-law (MIL) had a series of strokes that ended up putting her in the hospital with a UTI that had turned into sepsis. That was 5yrs ago. It all rendered her unable to walk, and she has limited ability to talk. She can sit in a wheelchair for about an hour or so before needing to lay down in bed. She is unable to use her right arm. She has limited use of her left arm. There has been no change in her condition in the last 5yrs.

However within the last couple of weeks, I've noticed that when she's eating, she bites her tongue and/or her bottom lip at least one or more times per meal. She also seems to be mildly choking on her food more often, like every other meal versus rarely. I'm concerned that she's deteriorating in some capacity.

I should also add that she had a very mild case of COVID back in June. It was only a mild cough, and they only tested her for it because the woman in the room next door to her got very sick. The cough went away after a week or two. She did yawn a lot for about a month after the cough went away. This was the first time she had gotten COVID.

She just had a check up with her doctor a month ago, and her stats were the same except that she was a little anemic.

I've read that trouble eating has to do with pons function, and can be affected in stroke victims, but I've only found references to that as something that happens at the time of the stroke, and not something that develops later on it's own without a catalyst. Could her mild case of COVID have been the catalyst? Could this be related to different cause (her mother has dementia)? Wondering if anyone else has experience with this happening to their loved ones?